SPOTLIGHT
THE EYE OF A SURVIVOR
While cure remains a goal , unique issues arise when treating professional and amateur athletes for hematologic conditions .
● ATHLETIC COMPETITION on an elite level depends on substantial training to optimize performance , and while many may not think of it , blood ’ s role is front and center .
“ Having an adequate oxygen-carrying capability is critical for endurance and strength training , as well as cognitive ability such as complex decision-making ,” said Alexandra M . Stevens , MD , PhD , assistant professor in the Department of Pediatrics at Baylor College of Medicine , and member of the leukemia program at Texas Children ’ s Hospital .
Other blood functions are crucially important , such as adequate white blood cell count to prevent infection in team environments and normal platelet counts to ensure clotting if injury occurs .
“ Athletes need to have almost no limitations , in terms of fatigue and pain , when training and competing . They need to be able to perform at their best ,” said Lewis Hsu , MD , PhD , professor of pediatric hematology-oncology and director of pediatric sickle cell at University of Illinois at Chicago . “ Having a chronic disease basically has the potential to put the brakes on you when you want to go full throttle .”
Unfortunately , athletes – elite or otherwise – are not immune to the development of disease .
The most famous athlete diagnosed with a lifealtering disease is likely baseball player Lou Gehrig , whose disease amyotrophic lateral sclerosis , or ALS , is still referred to as “ Lou Gehrig ’ s disease .”
Gehrig retired at the tail end of a Hall-of-Fame career . But , much more often , athletes are diagnosed with a life-changing disease in the middle of their professional careers , or even before they ’ ve begun . Thanks to advances in diagnosis and treatment , though , athletes with hematologic malignancies can expect to continue in their careers . ASH Clinical News spoke with doctors who have treated professional athletes living with blood diseases about the special considerations for their treatment and advances in treatment that have allowed patients to continue playing at the highest levels .
A Comeback Story
On top of the damage caused by a hematologic disease itself , side effects of the treatments can also affect athletic performance , explained Izidore S . Lossos , MD , head of the hematological malignancies site disease group at the University of Miami Sylvester Comprehensive Cancer Center .
Therapies for blood cancers can cause decreased blood count , anemia , weakness and fatigue , and gastrointestinal effects ; other medications can induce damage to vital organs like the lung , heart , or kidneys .
“ The reality is that , even if someone recovers from the disease , a team will very carefully evaluate risk before signing a contract ,” Dr . Lossos said .
Dr . Lossos witnessed this when he treated Anthony Rizzo , who presented to Sylvester Comprehensive Cancer Center in 2008 for treatment of Hodgkin lymphoma . ( Editor ’ s note : ASH policy is to protect patients ’ identities . The patients referenced in this article are public figures who have spoken publicly about their illnesses and are therefore identified by their full names .) One year earlier , at age 17 , Rizzo had been drafted to the Boston Red Sox and was playing minor league baseball in South Carolina . He came to Dr . Lossos with fatigue and edema of the legs and was diagnosed with stage III Hodgkin lymphoma and nephrotic syndrome .
“ He was losing albumin in the urine , accumulating fluids , and gaining weight ,” Dr . Lossos recalled . “ His presentation was very complicated and , with nephrotic syndrome , renal failure was definitely a concern .”
Rizzo had an International Prognostic Score of 3 , which is associated with a five-year overall
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